Summary Secondary syphilis is a rare infectious sexually transmitted disease caused by Treponema pallidum in present era. It affects skin as well as other organs of the body. We hereby present a case of an adult male who presented with a one-month history of multiple brownish red maculopapular lesions all over the skin of the body involving the palms, soles, oral cavity and genitalia. His serology was positive for HIV, VDRL and TPHA with a low CD4 count. The patient was treated with three weekly doses of parenteral Benzathine penicillin G, antiretroviral therapy and podophyllin for condyloma acuminata to which he responded well.
Sexually Transmitted Diseases ; Neurosyphilis ; Condylomata Acuminata

Objective: To investigate the distribution of the gene subtypes of human papillomavirus (HPV) in male patients with condyloma acuminatum (CA) and analyze the characteristics of the gene subtypes. METHODS: We extracted genomic DNA of the HPV virus from the genital tissue of 70 male CA patients, detected the DNA subtypes of HPV using the PCR-reverse dot hybridization technique, and analyzed the rates of different subtypes identified and their characteristics of distribution in different age groups. RESULTS: The male HPV-positive patients were mainly infected at the age of 20－39 years, primarily with high- and low-risk mixed infection of various subtypes, which accounted for 61.54% in the 20- to 29-year-olds and 42.86% in the 30- to 39-year-olds. Among the 70 CA patients, 22 HPV subtypes were identified, the top five subtypes including HPV 11 (21.08%), HPV 6 (19.46%), HPV 42 (6.49%), HPV 59 (6.49%) and HPV 53 (5.95%); 20 infected with a single subtype (28.57%), 19 with two subtypes (27.14%) and 31 with three or more (44.29%); and 30 infected with a low-risk single subtype (42.86%) and 40 with both high- and low-risk multiple subtypes (57.14%). CONCLUSIONS Male patients with CA are mainly infected with HPV 11 and HPV 6, with a significantly higher rate of multi-subtype than single-subtype infection, and the multi-subtype patients chiefly with high- and low-risk mixed infection. Men aged 20－39 years old are most commonly affected by CA.
Adult ; Condylomata Acuminata/virology* ; DNA, Viral/genetics* ; Genotype ; Humans ; Male ; Papillomaviridae/genetics* ; Papillomavirus Infections/virology* ; Young Adult

Ingenol mebutate (IM) is approved for the treatment of actinic keratosis and induces cell death in precancerous lesions. The efficacy of IM in the treatment of genital warts was investigated in a therapy-refractory patient. The 74-year-old male was treated with IM gel for three consecutive days. Treatment course and efficacy were evaluated by clinical inspection and non-invasive diagnostics namely optical coherence tomography (OCT) and reflectance confocal microscopy (RCM). Within 24 to 48 hours IM induced a strong local inflammatory reaction. One week later a complete response was observed. OCT and RCM showed a strong reaction after treatment with erosions, swelling of cells, and a subepidermal dark band in representative lesions. IM has the advantage of a short treatment period in contrast to other topical treatments and shows a promising clinical outcome. Larger studies are needed to validate the data.
Aged ; Cell Death ; Condylomata Acuminata ; Humans ; Keratosis, Actinic ; Male ; Microscopy ; Microscopy, Confocal ; Tomography, Optical Coherence

BACKGROUND AND OBJECTIVES: Potassium hydroxide (KOH) is effective and safe as treatment of viral dermatoses. No systematic review has been done reporting its efficacy as a treatment for anogenital warts.

METHODS: A systematic literature search for controlled clinical trials using KOH, any drug or ablative procedure measuring the clearance rate was conducted. Analysis was done using RevMan v5.3 software.

RESULTS: Four low quality trials, composed of 197 patients were included but only two qualified for meta-analysis. Two studies compared KOH to cryotherapy while the two other trials compared KOH to intralesional 5-fluorouracil (FU) + salicylic acid (SA) and carbon dioxide (CO2) laser vaporization. The KOH group showed a higher clearance rate compared to cryotherapy (RR= 1.40, P> 0.05, I2=39 %) and no recurrence was noted (RR= 0.17, P> 0.05, I2=0) but the difference is not statistically significant. Isik et al., 2014 and Asadi et al., demonstrated that there was no significant difference among groups receiving KOH, 5-FU+SA and CO2 laser vaporization in the mean lesion count and size at follow up visits. (P > 0.05).

CONCLUSIONS: Potassium hydroxide has comparable efficacy to the present treatment modalities but well-structured RCTs are needed to further support its use.

Psoriasis is an auto-immune skin disease, which is characterized by the excessive generation of plaques on the skin with typically a long-lasting red, itchy and scaly symptoms. Imiquimod, which has been used for the treatment of external genital warts, actinic keratosis, and superficial basal cell carcinoma, induced of psoriasis-like skin disorders with skin erythema and thickness in mice. In the present study, we tried to find the bioactive herbal extract against imiquimod-induced psoriasis-like skin disorder in mice. During the searching of the herbal extract with anti-psoriatic effect, the ethanolic extract of Cnidium officinale ameliorated imiquimodinduced psoriasis-like skin disorder in mice. The morphological evaluation, H&E staining and Psoriasis Area and Severity Index (PASI) score showed that ear and back thickness, and erythema induced by imiquimod were significantly reversed after the treatment of the cream of the ethanolic extract of C. officinale. The overexpressed myeloperoxidase (MPO) and keratin 6A levels were decreased by the treatment of C. officinale cream. Also, IFN-γ, c-fos and IκB-α mRNA levels, which are related to the progression of psoriasis, were reduced by C. officinale cream. Thus, the ethanolic extract of C. officinale ameliorated psoriasis-like skin disorder induced by imiquimod and might be the therapeutic agent for psoriasis.
Animals ; Carcinoma, Basal Cell ; Cnidium ; Condylomata Acuminata ; Ear ; Erythema ; Ethanol ; Keratin-6 ; Keratosis, Actinic ; Mice ; Peroxidase ; Psoriasis ; RNA, Messenger ; Skin Diseases ; Skin

Pigmented extramammary Paget's disease (PEMPD) is an uncommon intraepithelial adenocarcinoma and a rare variant of Paget's disease, characterized as a superficial pigmented scaly macule clinically and an increased number of melanocytes scattered between the Paget's cells histologically. So it may be confused clinically and histologically with melanocytic tumors, dermatitis and other dermatoses. Different therapeutic attitudes are required in this case of adenocarcinoma in situ as opposed to melanoma and dermatitis. Condyloma acuminatum (CA) is a common sexually transmitted disease caused by human papilloma virus infection, which is also called as genital warts. In this article, we first reported a case of a 65-year-old Chinese man who had pigmented extramammary Paget's disease complicated with CA. This patient presented with verrucous papules on the scrotum for 3.5 years, infiltrative erythema with itch on the mons pubis for 3 years, and scrotum and penis involved gradually for 4 months. Physical examination showed a 8 cm×10 cm dark red patch on the upper part of the scrotum, penis and mons pubis, as well as few maculopapules and nodules. Histopathologic examination of the lesion on the scrotum revealed a focus of Paget's disease, characterized by the presence of large round cells with abundant pale or granular/dusty cytoplasm, pleomorphic vesicular nuclei and prominent nucleoli (Paget's cells), while the histology of the verrucous lesion was consistent with CA. Immunohistochemistry was performed, which showed diffuse positive staining with CK, CEA, PAS, CK20, EMA, CK7, and Ki-67 (40%), HER2 in Paget's cells and negative with P53, P16, CK5/6, S100, MelanA, HMB45, estrogen receptor, progesterone receptor, and gross cystic disease flid protein 15 (GCDFP15). Human papillomavirus-11 (HPV-11) was positive by genotyping using gene amplification in the lesion of scrotum. According to clinical features and laboratory findings, a diagnosis of PEMPD complicated with CA was made. Local excision of the lesion was performed and sent for histological examination, with all margins clear of tumor. Both aforementioned diseases often occur in the vulva. Even so, it has been rarely reported coexisting of the above two diseases, of which the clinical significance and association are also unclear. In this article, we also reviewed the literature relating to PEMPD, and on this basis, the profile of this disease is discussed including its pathogenesis, clinical manifestation, diagnosis, treatment and advances. Due to PEMPD occasionally accompanied with an underlying carcinoma, it's essential to make an accurate diagnosis. Besides, review of the literature reveals that pigmented variant of Paget's disease could be initially misdiagnosed as melanocytic tumors and other dermatoses unless the entity is considered in the differential diagnosis and additional confirmatory studies are performed.
Aged ; Condylomata Acuminata/complications* ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Male ; Melanoma ; Paget Disease, Extramammary/pathology* ; Penis ; Scrotum/pathology*

Virus-like particles (VLPs) derived from human papillomavirus (HPV) L1 capsid proteins were used for HPV quadrivalent recombinant vaccine. The HPV quadrivalent vaccine is administrated in a 3-dose regimen of initial injection followed by subsequent doses at 2 and 6 months to prevent cervical cancer, vulvar, and vaginal cancers. The type 6, 11, 16, or 18 of HPV infection is associated with precancerous lesions and genital warts in adolescents and young women. The HPV vaccine is composed of viral L1 capsid proteins are produced in eukaryotic expression systems and purified in the form of VLPs. Four different the L1 protein of 3 different subtypes of HPV: HPV11, HPV16, and HPV18 were expressed in Escherichia coli divided into 2 fragments as N- and C-terminal of each protein in order to examine the efficacy of HPV vaccine. Vaccinated sera failed to recognize N-terminal L1 HPV type 16 and type 18 by western blot while they detected N-terminal L1 protein of HPV type 11. Moreover, the recombinant C-terminal L1 proteins of type 16 was non-specifically recognized by the secondary antibody conjugated with horseradish peroxidase. This expression and purification system may provide simple method to obtain robust recombinant L1 protein of HPV subtypes to improve biochemical analysis of antigens with immunized sera.
Adolescent ; Blotting, Western ; Capsid Proteins ; Condylomata Acuminata ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Female ; Horseradish Peroxidase ; Humans ; Methods ; Papillomaviridae ; Recombinant Proteins* ; Uterine Cervical Neoplasms ; Vaginal Neoplasms

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection and is associated with the development of cervical cancer. The purpose of this report is to provide the literature evidences on selecting the HPV vaccine for national immunization program (NIP) in Korea. To complete these tasks, we reviewed domestic and foreign literature on the current status of HPV infection, efficacy and effectiveness of HPV vaccine, safety of vaccine and cost effectiveness analysis of vaccination business. Given that the median age of first sexual intercourse is continuing to fall, this may have serious implications for HPV infection and cervical cancer incidence at the age of 20s. The World Health Organization recommends that the HPV vaccination should be included in the NIP being implemented in each country. Both the bivalent and quadrivalent vaccines have a 90% or greater preventive efficacy on cervical intraepithelial lesion 2–3 and cervical cancer by the HPV 16 or HPV 18. In the future, if HPV vaccination rate as part of NIP increases, it is expected that the incidence of HPV infection, genital warts, and cervical precancerous lesions will be decreased in the vaccination age group. Therefore, in order to increase the HPV vaccination rate at this point in Korea, social consensus and efforts such as the introduction and promotion of HPV vaccine to the NIP according to appropriate cost-effectiveness analysis are required.
Coitus ; Commerce ; Condylomata Acuminata ; Consensus ; Cost-Benefit Analysis ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Immunization Programs* ; Immunization* ; Incidence ; Korea* ; Papillomavirus Infections* ; Sexually Transmitted Diseases ; Uterine Cervical Neoplasms ; Vaccination* ; Vaccines ; World Health Organization

Photodynamic therapy is mainly used in dermatology to treat skin tumors, precancerous lesions, and condyloma acuminatum. Due to its excellent tissue selectivity, easy operation and good cosmetic effect, it has been gradually applied to the treatment of various non-neoplastic skin diseases, such as verruca acuminata, acne, rosacea, chronic skin ulcer, fungal diseases, keloid, and so on. Here is the review on the advancement in photodynamic therapy for non-neoplastic skin diseases.
Acne Vulgaris ; radiotherapy ; Condylomata Acuminata ; radiotherapy ; Humans ; Photochemotherapy ; Research ; trends ; Skin Diseases ; radiotherapy

Adult ; Aminoquinolines ; adverse effects ; therapeutic use ; Condylomata Acuminata ; drug therapy ; Female ; Humans ; Hypopigmentation ; chemically induced ; diagnosis ; Male ; Middle Aged ; Vitiligo ; chemically induced ; diagnosis